Early outcomes following elective laminoplasty: A comparison of surgical specialties using the National surgical Quality Improvement Program (NSQIP) database

Abstract

Study designRetrospective cohort study. ObjectiveThe objective of this study was to compare early outcomes in patients following cervical laminoplasty based upon surgeons’ specialty and compare preoperative comorbidities and operative characteristics. Summary of background dataCervical laminoplasty is a common procedure in patients presenting with cervical myelopathy secondary to spinal stenosis. Given this, it is routinely performed by both neurosurgeons and orthopedic spine surgeons. Surgeons’ training in different specialties could play a role in patients’ related outcomes when performing the same procedure. MethodsA retrospective review was conducted using the National Surgical Quality Improvement Program (NSQIP) database of all patients undergoing elective cervical laminoplasty identified by CPT code 63,050 and 63051. Preoperative demographics and comorbidities were evaluated. Following this, operative characteristics and complication rates were compared. Propensity score matching was used to adjust confound variables for the rate of complications. ResultsA total of 2708 cases were analyzed from the NSQIP database that met the inclusion criteria. Of these, there were 1143 cases in the orthopedic surgery cohort and 1565 cases in the neurosurgery cohort. Neurosurgery patients have a higher rate of preoperative dyspnea, hypertension, ASA class of 3 or more, and lower rates of clean wound class. Orthopedic surgery patients were more likely to have a longer operation time, while neurosurgery patients demonstrated a longer length of stay. Following propensity matching for comorbidities, neurological surgery patients were more likely to have unplanned readmissions, wound dehiscence, and pulmonary emboli (p < 0.05). ConclusionsIn conclusion, cervical laminoplasty is a safe and effective procedure when conducted by both orthopedic spine surgeons and neurosurgeons. In our series, neurosurgical patients were more likely to have higher rates of preoperative comorbidities and higher complication rates.